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EP0589468A2 - Sonde à laser médicale et méthode d'application de radiation CO2 - Google Patents

Sonde à laser médicale et méthode d'application de radiation CO2 Download PDF

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Publication number
EP0589468A2
EP0589468A2 EP19930115423 EP93115423A EP0589468A2 EP 0589468 A2 EP0589468 A2 EP 0589468A2 EP 19930115423 EP19930115423 EP 19930115423 EP 93115423 A EP93115423 A EP 93115423A EP 0589468 A2 EP0589468 A2 EP 0589468A2
Authority
EP
European Patent Office
Prior art keywords
radiation
probe
probe according
guide
hollow
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP19930115423
Other languages
German (de)
English (en)
Other versions
EP0589468A3 (en
Inventor
James A. C/O Rutgers University Harrington
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Heraeus Surgical Inc
Original Assignee
Heraeus Surgical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Heraeus Surgical Inc filed Critical Heraeus Surgical Inc
Publication of EP0589468A2 publication Critical patent/EP0589468A2/fr
Publication of EP0589468A3 publication Critical patent/EP0589468A3/en
Withdrawn legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
    • G02B6/02—Optical fibres with cladding with or without a coating
    • G02B6/032—Optical fibres with cladding with or without a coating with non solid core or cladding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
    • B23K26/064—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/12—Working by laser beam, e.g. welding, cutting or boring in a special atmosphere, e.g. in an enclosure
    • B23K26/127—Working by laser beam, e.g. welding, cutting or boring in a special atmosphere, e.g. in an enclosure in an enclosure
    • B23K26/128—Laser beam path enclosures
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/14—Working by laser beam, e.g. welding, cutting or boring using a fluid stream, e.g. a jet of gas, in conjunction with the laser beam; Nozzles therefor
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
    • G02B6/10—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings of the optical waveguide type
    • G02B6/102—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings of the optical waveguide type for infrared and ultraviolet radiation
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
    • G02B6/24—Coupling light guides
    • G02B6/36—Mechanical coupling means
    • G02B6/38—Mechanical coupling means having fibre to fibre mating means
    • G02B6/3807—Dismountable connectors, i.e. comprising plugs
    • G02B6/3873—Connectors using guide surfaces for aligning ferrule ends, e.g. tubes, sleeves, V-grooves, rods, pins, balls

Definitions

  • the present invention relates to laser systems and, more particularly, to a probe for delivering 10.6 micron wavelength radiation and a method for such delivery.
  • CO2 (carbon dioxide) laser radiation is of major interest to the medical community because of the ability of the principle component of its output radiation, 10.6 microns in wavelength, to cut and/or ablate both normal and abnormal mammalian tissue when delivered at appropriate power levels.
  • delivery systems for conveying the same to a mammalian tissue site have been less than ideal -- this is particularly true for internal deliver.
  • the delivery system must be both flexible and preferably sufficiently small at its distal end for cavity insertion and intracavity manipulation.
  • a critical component in such delivery is the optical waveguide which directs the radiation from a source of the same to adjacent the desired mammalian tissue site. (If the waveguide is connected directly to a CO2 laser to receive its output, the source is the laser itself, whereas if the delivery system is a multi-component system the source can be another component of the system.)
  • the characteristics that are desired in a medical probe for CO2 laser radiation are known. It is desirable that it be small as mentioned above, i.e., small in dimension in the direction normal to the direction of guiding. Surgeons prefer that the greatest dimension in such direction of any part which may be inserted internally into a body, be no greater than 1 millimeter. It is also quite important that it be flexible, i.e., capable of being flexed, without major variations in its transmission capability. In connection with the latter, a surgeon has to be able to expect basically the same output power from the probe irrespective of variations in probe flexing.
  • the portion of the guide, the operative part of the probe, which is to be inserted into a body be fairly long, e.g., about 75 centimeters in length. This means that the transmission loss per unit of length has to be minimized.
  • This phenomenon has been associated with the index of refraction (n) of the alumina relative to the wavelength. That is, this relatively unexpected phenomenon has been associated with the index of refraction of the alumina becoming less than that of the air core over a short range of wavelengths.
  • Probe constructions using polycrystalline material as a cladding in which some flexing can be achieved have been considered. For example, it has been considered to provide a thin coating or layer of a polycrystalline material within an otherwise flexible substrate tubing. While such a construction may permit flexing, relatively high transmission losses would be expected due to the polycrystalline nature of the coating.
  • a hollow waveguide in which the index of refraction of the cladding of the waveguide (the material providing the cladding) is less than that of the core can be made flexible and yet transmit 10.6 micron radiation upon flexing without appreciable loss if the cladding material is a single crystal material.
  • the core of a hollow waveguide in most instances is air having an index of refraction of 1.
  • a hollow waveguide of the type to which the invention relates is commonly referred to as a "n ⁇ 1" waveguide.
  • the single crystal material is sapphire. It has been found that when tubular sapphire having a length of 91 centimeters for a probe was flexed, there was essentially no material difference in transmission loss of 10.6 micron radiation compared to an unflexed tube. This was found to be true even when the sapphire tube was bent to a radius of curvature of 28 centimeters. (such probe sapphire tube had an internal diameter of 400 microns.) Moreover, the overall transmission loss was only 3.5 dB/m.
  • the body of the probe itself acts as a waveguide for visible radiation having a wavelength of 0.63 microns emanating from a HeNe (helium-neon) laser.
  • the tubular sapphire provides two functions - it acts as the desired flexible single crystal probe for 10.6 radiation and acts to furnish the necessary light to illuminate a site.
  • the cladding construction be transparent or translucent to visible radiation and is a guide for directing illuminating radiation to the site.
  • the optical guide is provided in two sections, a main optical guide section and a replaceable or disposable tip section.
  • Both sections most desirably are hollow, air core guides through which a purge gas, such as nitrogen, can be passed during use of the same.
  • a purge gas such as nitrogen
  • both sections are hollow waveguide sections it is preferable that the inner diameter of the tip section waveguide be greater than that of the main body section so that misalignment between the two has little effect on the ability to guide radiation at the joint between such sections.
  • Fig. 1 is a schematic illustration of the relationship of a probe of the invention to a laser medical system and mammalian tissue to be treated.
  • the medical probe generally referred to by the reference numeral 11, is illustrated receiving radiation from a source of such radiation represented as radiation delivery system 12.
  • a source of such radiation represented as radiation delivery system 12.
  • Such system receives 10.6 micron coherent radiation from a CO2 laser 13 to be delivered to an operating site on mammalian tissue represented at 14. It also receives illuminating 0.63 micron radiation (light) from a HeNe laser represented at 16 to be delivered to the site.
  • FIG. 2-4 A preferred embodiment of the probe of the invention is illustrated in detail in Figs. 2-4.
  • Such embodiment includes a standard connector structure 17.
  • This embodiment is designed to convey both the desired 10.6 micron operating radiation and illuminating radiation.
  • connector 17 is capable of connecting the probe appropriately to a delivery system to receive both 10.6 micron coherent radiation in the hollow core of the waveguide tube which will be described, as well as 0.63 micron illuminating coherent radiation in its body.
  • the probe further includes a body fitting 18 which acts as physical structure registering with the connector 17 as illustrated.
  • the principle component of the probe is a sapphire tube, generally referred to by the reference numeral 19.
  • Tube 19 has an inner diameter (ID) of 400 microns, an outer diameter (OD) of 575 microns, and is 91 centimeters long. It functionally acts as the waveguide cladding for the 10.6 micron radiation and has an index of refraction of approximately 0.7 for 10.6 micron radiation at such wavelength, whereas the core of the guide (air) has an index of refraction of 1 for such radiation.
  • the sapphire tube of the preferred embodiment of the invention is an n ⁇ 1 guide for 10.6 micron radiation. It extends as illustrated through the connector 17 to receive such radiation from the delivery system.
  • the tube extension also permits receipt by the translucent sapphire body itself, i.e., between its ID and OD, of illuminating 0.63 micron radiation originated by HeNe laser 16 to follow the 10.6 micron radiation to the site.
  • the illuminating radiation will form a circle circumscribing the 10.6 radiation at the tissue site. This will simplify visual identification of the location of the principle radiation and is a natural consequence of the tubular shape of the sapphire.
  • sapphire tube 19 is monocrystalline and is flexible, and it has been found that flexing (bending) of such single crystal material to a degree typically encountered in surgery, does not result in significant changes in the power of 10.6 micron radiation which is transmitted. It therefore enables the probe of the invention to be used quite reliably. That is, a user of the probe, such as an operating surgeon, will accurately have at the free or distal end of the probe an amount of output radiation that does not vary materially irrespective of any flexing or bending of the probe which may be necessary during an operation. In this connection, it has been found that less than 30% transmission loss deviation can be expected for the tube having the dimensions set forth above when flexed to a 28 centimeter bend radius.
  • the c-axis of the crystal lattice structure extends in the direction of guiding by the tubing, i.e., along its optic axis. This is a high strength orientation that is selected to prevent the cleavage plane from being perpendicular to the optic axis. In aligning the c-axis parallel to the optic axis, one keeps the modulus of rupture high and minimizes fracture due to cleavage.
  • the absorption loss in an air core hollow waveguide of radiation having a particular wavelength is directly proportional to the value of k, the extinction coefficient of the cladding material. That is, the complex refractive index N of the cladding material is equal to n - ik, where n is the refractive index and k is the extinction coefficient. It is particularly important that the value of k be small at the wavelength of interest when one considers loss due to bending, because the angle of incidence of the radiation is greater in a bent or flexed guide than it is in a straight guide and there are more internal reflections in the former, resulting in a longer path length.
  • One other advantage of sapphire tubing attributable to its single crystal nature is the fact that upon flexing, it does not change the mode makeup of the 10.6 micron radiation that it guides. That is, if a single mode, such as the TEM00 mode, of 10.6 radiation is fed into the same, the output radiation also will be of such single mode irrespective of reasonable flexing. In contrast, if hollow waveguides of polycrystalline or amorphous materials are flexed or built with a fixed curve, they will typically separate a single mode of 10.6 micron radiation into multiple, higher order modes. Each of these modes will be directed by the guide to different spot locations, with the result that the transmitted power will be spread out rather than concentrated at a single spot as desired.
  • sapphire neither loses its structural integrity nor its optical properties when exposed to high temperatures, e.g., 1500°C., such as can be expected if radiation cannot exit the end of the probe because of, for example, clogging or the like. It also is chemically inert and biocompatible.
  • the probe of the invention illustrated in Figs. 2-4 also includes a coating 21 of a material, such as a tetrafluoroethylene fluorocarbon polymer or fluorinated ethylenepropylene resin by, among others, E. I. du Pont de Nemours and Co. sold under the trademark TEFLON.
  • a coating 21 of a material such as a tetrafluoroethylene fluorocarbon polymer or fluorinated ethylenepropylene resin by, among others, E. I. du Pont de Nemours and Co. sold under the trademark TEFLON.
  • Such coating is a part of a protective covering for the tube 19 and acts as a buffer between sapphire tubing 19 and an exterior protective housing 22. If tubing 19 should fracture, coating 21 will also tend to maintain adjacent ends of the same in abutment with one another to reduce transmission losses caused by such breakage.
  • Protective housing 22 is most desirably flexible so that it will not interfere with the inherent flexibility of the tubing 19. In this connection,
  • the protective covering including coating 21 and housing 22, extends for substantially the full length of the tubing. In this connection, it extends through the fitting 18 into the connector 17 as illustrated.
  • neither housing 22 nor coating 21 are needed. That is, sapphire tubing 19 has enough structural strength to withstand normal usage and provide adequate structural resistance to withstand the environment within which the probe will be used. In other situations, the invention can be employed with only a housing or a coating, but not both.
  • the housing 22 of the protective outer covering is shaped at the exit end of the waveguide to prevent the sapphire tubing from existing the probe at such end.
  • a surgeon or other user of the probe therefore need not be concerned that breakage of the tubing will result in pieces of the same exiting the probe at the site to which the radiation is being directed.
  • Fig. 4 illustrates the exit end shape of the outer housing covering which is responsible for preventing exiting of the tubing guide at such location. That is, housing 22 is directed inwardly of the probe structure adjacent the radiation exit end 23 to overlap the end of tubing 19.
  • An advantage of using the hollow guide is that a purging gas, such as nitrogen, can be passed through the same for delivery along with the radiation to the site.
  • the gas can be introduced into the interior of the guide through, for example, the connector 17 as schematically illustrated at 24.
  • the protective housing 22 has an outer diameter of 1.0 millimeters and an inner diameter of 0.9 millimeters.
  • Coating 19 is provided with a thickness of 0.15 millimeters to assure that there is a tight structural fit between the actual optical guide and its protective covering.
  • the probe of the invention satisfies the major requirements of surgeons. That is, it delivers the desired 10.6 micron radiation to a tissue site with a minimum of transmission loss while yet being flexible. (In this connection, it is uniformly flexible along its length except, of course, for that portion of its length which is taken up by the connector 17 and fitting 18.) Most importantly, the power output of the probe does not materially change when the degree of flexing changes.
  • the embodiment of the probe illustrated in Figs. 5 and 6 adds another desirable feature to the features discussed above.
  • Such probe has two sections, a main optical guide section 26 and a tip section 27.
  • the main section is designed to receive the radiation and, in this connection, include both a fitting 18' and a connector (not shown) which are the same as the fitting and connector in the earlier described embodiment.
  • the tip section is designed to receive the radiation from the main guide and guide the same to adjacent the desired site.
  • Such tip section is separable from the main section to thereby become, in essence, a disposable tip. That is, a surgeon may replace the tip on a guide while retaining the main portion of the probe for reuse.
  • a tip coupling made up of two mating cylindrical parts 28 and 29 is provided to facilitate separable connection.
  • the tip part 28 of the coupling includes a threaded bore circumscribing the probe, and the main part 29 has a threaded cylindrical extension 31 designed to threadably mate within such bore.
  • the parts 28 and 29 can be threaded together to tightly mate with one another.
  • the remainder of both sections of the probe having sapphire tubing 19' and a protective outer covering comprising a coating 21' and a housing 22' as described above abut tightly against one another when the coupling parts also abut one another. (It will be noted that this embodiment of the invention is the same, except as described, as the embodiment illustrated in Figs. 2-4.)
  • the inner diameter of the hollow waveguide of the tip section is greater than that of the main body section. This enhances the lack of coupling loss at the joint. That is, misalignment between the two sections at the joint when they are coupled together is accommodated, so that there is no guide discontinuity at the joint facing radiation travelling between the two sections.
  • the guide of the tip section had an ID of 1.05 millimeters, whereas the main section had an ID of 0.8 millimeters.
  • the material of the hollow guide of the tip section be the same as that of the main body section.
  • such tip section could be inflexible (assuming, of course, that it is relatively short in length) and have a cladding of another material.
  • such tip section can be of a polycrystalline material, such as alumina, or even of an amorphous material.
  • tip section could have a different guiding structure altogether than the main section, most desirably it also is a hollow wave guide so that a purging gas can be passed through both it and the main section.
  • a purging gas system such as in the earlier described embodiment can be utilized with the same.

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  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Mechanical Engineering (AREA)
  • General Physics & Mathematics (AREA)
  • Plasma & Fusion (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Toxicology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Electromagnetism (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)
  • Radiation-Therapy Devices (AREA)
  • Optical Fibers, Optical Fiber Cores, And Optical Fiber Bundles (AREA)
EP19930115423 1988-04-14 1988-12-23 Medical laser probe and method of delivering co2 radiation Withdrawn EP0589468A3 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US07/181,448 US4911712A (en) 1988-04-14 1988-04-14 Medical laser probe
US181448 1998-10-28

Related Parent Applications (2)

Application Number Title Priority Date Filing Date
EP88312275.6 Division 1988-12-23
EP19880312275 Division EP0338166A3 (fr) 1988-04-14 1988-12-23 Méthode d'application de radiation CO2

Publications (2)

Publication Number Publication Date
EP0589468A2 true EP0589468A2 (fr) 1994-03-30
EP0589468A3 EP0589468A3 (en) 1994-06-15

Family

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Family Applications (2)

Application Number Title Priority Date Filing Date
EP19880312275 Ceased EP0338166A3 (fr) 1988-04-14 1988-12-23 Méthode d'application de radiation CO2
EP19930115423 Withdrawn EP0589468A3 (en) 1988-04-14 1988-12-23 Medical laser probe and method of delivering co2 radiation

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP19880312275 Ceased EP0338166A3 (fr) 1988-04-14 1988-12-23 Méthode d'application de radiation CO2

Country Status (4)

Country Link
US (1) US4911712A (fr)
EP (2) EP0338166A3 (fr)
JP (1) JPH01262856A (fr)
IL (1) IL88746A (fr)

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EP1740988A4 (fr) * 2004-04-08 2008-11-12 Omniguide Inc Fibres a cristaux photoniques et systemes medicaux comprenant des cristaux photoniques
US7991258B2 (en) 2004-04-08 2011-08-02 Omniguide, Inc. Photonic crystal fibers and medical systems including photonic crystal fibers
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US11051842B2 (en) 2017-05-03 2021-07-06 Medtronic Vascular, Inc. Tissue-removing catheter with guidewire isolation liner

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EP0338166A3 (fr) 1991-03-06
JPH01262856A (ja) 1989-10-19
EP0338166A2 (fr) 1989-10-25
IL88746A (en) 1994-05-30
US4911712A (en) 1990-03-27
EP0589468A3 (en) 1994-06-15
IL88746A0 (en) 1989-07-31

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